The Feasibility of Three-port Technique in Laparoscopic Cholecystectomy

Background: Nowadays, laparoscopic cholecystectomy is the gold standard treatment for symptomatic gall stone diseases. Traditionally, laparoscopic cholecystectomy has been performed through four ports. According to the literature, three-port technique is technically feasible, safe, and cost advantages over the four-port technique. However, three-port technique should not be used at the expense of safe dissection of Calot’s triangle. Objective: The main aim of this study is to evaluate the feasibility of three-port technique without affecting patient safety in laparoscopic cholecystectomy. Methods: This is the hospital based interventional prospective descriptive study. All patients who underwent laparoscopic cholecystectomy at No (2) Military Hospital (500-Bedded) during October 2023 to April 2024 were included. The same surgeon performed all operations. The demographic data, intraoperative and postoperative outcomes such as bleeding, visceral injury, bile spillage, requirement of added port, conversion to open surgery, operating time, postoperative complications and postoperative pain were determined. Results and discussion: This study included 66 patients. The mean age of patients was 54.7 years. The number of patients required added port was 4 out of 66. One patient needed conversion to open surgery. The success rate of the present study was 92.4 percent. The mean operative time was 62.4 minutes. Intraoperative and postoperative outcomes were illustrated in tables. Most of the patients, 97 percent, encountered mild postoperative pain. Conclusion: Three-port technique is feasible without additional event to patient safety. It is also cost effective, as it needs fewer assistants and instruments. Therefore, laparoscopic cholecystectomy should be initially attempted with three ports. However, the surgeons need to have low thresholds for adding four ports if necessary.